CT Certification Admissions Application

COMPUTED TOMOGRAPHY CERTIFICATE PROGRAM
APRIL 2015 APPLICATION
INSTRUCTIONS:
Please read through the application through its entirety for pertinent details regarding the courses offered in the
Computed Tomography (CT) Certification Program. Applicants are to fill in all required information and
submit all mandatory documentation. The application must be completed in its entirety in order to be accepted
and considered for review.
SECTION I: REQUIRED APPLICATION INFORMATION
Please print legibly
Name: ______________________________________________________________________
(Last)
(First)
(MI)
Mailing Address:
_______________________________________________________________________________________
(No. and Street)
(City)
(State)
(Zip Code)
Phone Numbers: (_____)_______________________(_____)__________________________
(home)
(cell/work)
E-mail: ______________________________________________________________________
STC Student A# ________________________
Students who do not have a current A# will be issued one at the time of acceptance
SECTION II: COMPUTED TOMOGRAPHY PROGRAM DESCRIPTION
Thank you for your interest in the Computed Tomography (CT) Certificate Program at South Texas College!
This program is designed to provide an opportunity for professional and personal advancement in the medical
imaging profession. The courses provided in the CT Program are created to focus on physics and
instrumentation, imaging procedures, patient care and safety, and clinical competency requirements as outlined
in the American Registry of Radiologic Technologists (ARRT) Computed Tomography Examination.
Participants who meet all mandatory criteria will also earn continuing education (CE) credits that will be
awarded at the end of the program.
The CT Program consists of one didactic course and an optional practicum course. The didactic segment of the
program will be the first course that will be offered and the optional practicum segment will follow when the
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didactic course has been completed. The practicum component is geared towards participants who are unable to
complete their clinical competencies at their place of employment. In order to be accepted into the practicum
segment of the program, students must first enroll in the didactic course and pass it with a grade of a
satisfactory, in addition to meeting the STC Nursing & Allied Health Division clinical requirements.
The didactic course is 12-weeks in length with classes that are scheduled twice a week. This course information
and tentative class schedule is as follows:
Course Number and Title:
CTMT 2036.HZI: Computed Tomography Equipment and Methodology
Class Schedule:
April 14th – July 2nd
Tuesdays & Thursdays from 6:30 p.m.– 8:30 p.m. *
*This time will be extended during one class session in order to complete the final
examination.
Location:
NAHC Classroom 103
Dr. Ramiro R. Casso Nursing & Allied Health Campus
1101 E. Vermont Ave, McAllen, Texas 78503
CE Credits:
As per ASRT requirements, participants will only be awarded CE credits if they
have 100% attendance throughout this course. Partial credits will not be issued.
Participants who obtain one or more absences will be allowed to continue with the
course, but they will be unable to earn CE credits. The number of CE credits that
will be awarded is currently under review by the ASRT.
Course Tuition & Fees:
$600.00
SECTION III: APPLICATION REQUIREMENTS
Applicants must meet all of the following criteria in order to qualify for admission:
1. Current ARRT certification as a radiologic technologist, radiation therapist, or nuclear medicine
technologist. A copy of your certification card must be provided with your application for admission.
2. Current state certification in radiography, radiation therapy, or nuclear medicine. A copy of your
certification card must be provided with your application for admission.
3. Applicants must sign and date the completed application and provide a copy of the required certification
cards. The application packet must be scanned and emailed to Lorenna Trevino, Continuing Education
Operations Officer, at lori@southtexascollege.edu.
4. Class size is limited in this program and acceptance will be on a first come, first serve basis. If
there are more qualified applicants than openings, the candidates who are not accepted will be placed on
a waiting list for the next offering of the course, if they so choose.
5. For additional information please contact Lorenna Trevino via telephone at (956) 872-3584 or email to
lori@southtexascollege.edu. Additional information for the STC Continuing Education Department is
as follows:
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STC Pecan Plaza
2621 Pecan Blvd.
McAllen, TX 78501
SECTION IV: ACCEPTANCE INTO THE PROGRAM
Upon submission of the completed application, participants will receive a confirmation email from Ms. Trevino
to verify acceptance into the program. Students who are accepted will also receive instructions in course
enrollment and optional tuition payment plans.
SECTION V: APPLICANT ACKNOWLEDGEMENT AND SIGNATURE
Applicants must read and adhere to the following statements:
I have read the contents of this information packet and assume responsibility for my application’s completeness
and for the information contained within it. I certify that the information provided within this application is true
and realize that reporting untrue information will result in my disqualification from the applicant pool and
program and I will not be eligible to reapply.
SIGNED____________________________________________________
Applicant’s Signature
DATE________________
STATEMENT OF EQUAL OPPORTUNITY
No person shall be excluded from participation in, denied the benefits of, or be subject to discrimination under
any program or activity sponsored or conducted by South Texas College on the basis of race, color, national
origin, religion, sex, age, veteran status, or disability.
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